The aim of this study was to analyse and compare the activity pattern and technical-tactical parameters of men’s wheelchair tennis matches from the Paralympic Games (PG) in Athens 2004 (A), Beijing 2008 (B), London 2012 (L) and Rio 2016 (R). A total of 5702 shots from twelve final round matches were analysed. Activity patterns (e.g., rally duration, shots per rally…) and technical effectivity (e.g., errors, winners…) were recorded. An ANOVA test with post hoc pairwise comparisons was conducted to compare the mean differences among matches of different PG. Game duration, points and shots per game differed according to the PG (R and L > B and A). Rally duration (p < 0.001) and shots per rally (p < 0.001) were longer at R and L than B and A. The effectivity of the last shots was different, the errors have been increasing and the winners have been decreasing. The main finding indicates that activity patterns and technical parameters have evolved mainly between A and B to L and R. This study gives an overview of the development of the sport over time, and coaches can use this information to adapt their training sessions to the current needs of the competition.